Breath-holding experiences?

[suburbandweller]

DS (nearly 16mo) has recently started breath-holding to the point of losing consciousness, each time precipitated by a tantrum over something fairly trivial (most recently, over having his nose wiped and nappy changes). I know this is reasonably common so am not overly worried about it per se (and I did it as a baby, so have got some helpful support from DM), but it is quite distressing to watch my otherwise very happy and cheeky boy getting so overwrought that he passes out.

Does anyone else with a breath-holder have any tips over how to deal with an episode? Have tried distraction through both nursery rhymes and blowing in his face, neither of which seem to work.

I just hugged and cuddled my DD, but I'm not sure she actually realised anything had happened. I was really scared, as her eyes went all "roll-y".

Doctors weren't worried either. Hasn't happened for ages now.

DS was a breath holder but he held his breath when he was hurt which is slightly different. Agree with Sea that it seems a good idea just ho cuddle them and carry on. The hospital told us that they usually grow out of it by 2.5 years and often much earlier.

Thought you might find this helpful too .

Thanks for that Jilted; DS does it when he hurts himself sometimes too, although he's usually more easily distracted in those cases. Will carry on with the holding/cuddles until it passes!

DS did this for a while, it scared the hell out of me every time but it did stop eventually. It only tended to happen when he was tired so I learned when to expect it, he'd go purple then go floppy and then start breathing properly again. DS never likes comforting when he's upset and tired (makes things worse) so it was a case of watching carefully and if it happened then providing comfort as it scared him too. In DS it lasted from about 15-20 months, not had one now for ages - possibly coinciding with him being able to express why he's upset?

Thanks, have noticed that DS' episodes have so far all been when he's tired (he's gone for a nap pretty quickly afterwards) so I suppose it's all about looking for the signs. I agree it's probably partly down to frustration too - he's very chatty but not really forming recognisable words yet so doesn't always express himself in a way that I understand.

If you are having difficulty understanding him sometimes, have you thought about baby signing? You don't have to sign upto expensive classes as most libraries will have a book on how to do it.

Yes, I thought about baby signing when he was younger, although decided against it as he was always fairly good at making known what he wanted. I'm not sure it would help now as he is becoming more specific - so instead of wanting food/drink/to play, he wants a particular food, or to drink from a particular cup, or a particular toy. Of course it might just be typical toddler tantrum stuff and nothing to do with that at all!

My DD did this for a while but when she was older 2-3 our GP told us that as she was old enough to understand us that we should make sure we caught her when she did it but then when she came back round tell her that if she was that tired she should have a nap and put her to bed for 5 mins, if she slept then leave her otherwise after 5 mins let her come back down with everyone else. She also did it when hurt and he said to just cuddle and love then.

Not sure the going to bed would work with a younger one though, but if it carries on it is something to bear in mind. DD only did it twice once we put her to bed as she was then missing out, it stopped it so quickly and was so simple I couldn't believe it

DS (2.4) has done this since before he was 1. I have found that my response has changed as he has got older. When he was younger it would happen when he was hurt, upset and then frustrated or cross. Up til 18 mo I'm certain that his inability to articulate frustation was a big cause. I would cuddle him until he calmed down for most of this time. I found it very difficult to deal with and even though I knew that he wasn't going to do himself any damage, it upset me a great deal.

However - and some may disagree with me about this - from about 18 months onwards he started to use it as a manipulating tool more and more, to get his own way. We don't have so many now (ironically, given that we are in the middle of the terrible twos and blimey can he tantrum!!) but they are nearly always because he is trying to get his own way on something. I take a much harderline approach now and do my best to 'ignore'. Basically I make sure he can't hurt himself (he has been known to do it at the top of the stairs for example!), and stand over him and hold his shoulders, and just say 'calm down' (or nothing at all) and wait for him to get over it. I've never really totally ignored it, but I do make it quite clear now that I'm not terribly impressed with what he is doing. Often you can tell that he has lost control and wants to sort himself out, so once he's calmed down, I'll explain that it's ok to be frustrated (but that other children are also allowed to take turns, or whatever the triggering issue is). His language is excellent now, so it's not about not being able to articulate frustration.

Definitely a link with tiredness and hunger too. I do find myself having to explain to people that he's a breath-holder quite often as he typically does it when we're out and about (i.e. more likely to come into dispute with another child over a toy!) and it really freaks other people out and I think some of them are very at my seeming indifference to it.

p.s. If it looks like he's going to actually pass out, blowing in his face usually shocks him into breathing before that happens. At nursery they always do this.

I also have this with one of my DC (now 16mo). I asked DC's pediatrician about it last week and he said that it is a normal reflex action in some children. When they are hurt or upset, some children will cry the house down, whilst others will hold their breath and pass out briefly. It's all the 'same' reaction but in different ways. He advised me, to gently lie DC down when it happens and just wait for DC to come round (he acknowledged how difficult this could be in the situation!). Just keep an eye on whether lips and fingertips are still normal colour. If DC has clearly lost colour and gone blue then it is not normal and requires immediate action, same if they have actually had a fall and lost consciousness because of the fall (not just crying/holding breath). He said that DC may well cease to do it over time, if s/he sees you not 'over-reacting' by getting upset, blowing on face (which is what we've always done) and shouting to keep them awake etc (also what we've done), but just laying them down and waiting for them to come round again. He reassured me that they have enough oxygen in their body so that nothing is going to happen and they are still perfectly ok.

Having said all that though, I don't know if I would be able to actually follow his advice if it happens again!

Have now read WizzyBizzy's post above, what she says echoes what my doctor said - that by laying them down if they pass out and not 'over-reacting' - but sort of ignoring it (in a nice way!) if they go into the holding breath thing - they will slowly get the message that it doesn't work and may cease to do it. I guess that applies as they get older and notice more that when they do something, it triggers a certain reaction in everyone around them, rather then when they're still quite young. But interesting my doctor's advice is same as Wizzy's experience.

DD did this up until 2 and then she used to make her self sick, sometimes it was the result of an accident but mostly when she couldn't get her own way.

What Wizzy said - DS did it a couple of times and he is normally the sunniest little chap so we made sure he was safe - lay him down as he folded- then left him to 'come round' and, as he settled to crying normally, held arms out so he could come for a proper cuddle and comfort without directly resulting from the strop...

Thanks for all these really helpful posts, there are some great tips for helping to deal with this. The blowing in face thing hasn't worked for DS unfortunately but I'll definitely try the other suggestions, particularly if it seems as though DS is using breath-holding to manipulate situations as he gets older.

Interestingly, bouviergirl, DS actually goes a bit blue around the lips just before he passes out (it's one of the signs for us that he's about to lose consciousness), so for him it's a normal part of the whole breath-holding thing. I can see that if a breath-holder didn't come around quickly that it would be an indicator that something was wrong though, which I guess is what your DC's paediatrician was talking about.

It is difficult to deal with isn't it WizzyBizzy, even if you know that it's a common issue. I thought I was pretty laid back about it when it first happened as I knew that it wasn't anything to worry about, then I had a couple of nightmares about it so I realised it must have affected me subconsciously.

Sure is tough! One other thing to consider is how any one else who looks after your DS deals with it. We had a bit of a set back because DS totally freaked a couple of people out at nursery (there had been some staff changes so where people had been used to dealing with it a couple of people who came in weren't aware he did it and then didn't know what to do when it happened). As a result they started giving into everything he wanted, because they were afraid of it happening again and his behaviour noticeably deteriorated. It is sorted now, but they thought I was nuts when I first told them to (try to) ignore it as much as possible.

Another good tip, thanks! The first time it happened to DS he was at nursery actually - they called an ambulance as they thought he'd had a fit!It's only recently that it has happened at home so we've realised it was definitely breath-holding.

It hasn't happened at nursery since, but I think he's come close a couple of times - thankfully there is one experienced carer there who's very on the ball with this type of issue and she has advised the others on how to deal with it. I'm hoping he'll have grown out of it by the time he changes rooms but will definitely make sure I speak to any new carers just in case.

Oh god - DD2 used to do this when she hurt herself and it terrified the hell out of me! Once I realised what it was (unlike the first time when I rushed her to the GP!) I tried to stay really calm and blow into her face, which seemed to work for her. She never did it to the point of unconsciousness though - just to the point of lolling and eye-rolling and that was bad enough!

Does he actually hold his breath? Or does he stop breathing?

Two of my children have reflex anoxic seizures. This is often confused with breath holding, even doctors get confused with it. They do not breath-hold; they simply stop breathing, sometimes if they have hurt themselves, and sometimes due to high emotion.

It is not attention seeking; it is a physical reaction to emotions rather then an emotional reaction. It's very frustrating when people have told me that it is attention seeking and they are trying to manipulate me.

When they stop breathing, they lose consciousness and sometimes have a fit. They have both had EEGs and ECGs, and have both been found to be healthy. They have both grown out of it now. In my children's case, it is likely to be genetic because I think my dh had it. My middle child does not have it.

You can read more about reflex anoxic seizure on a website called 'STARS'.

Hi belgo, in DS' case it's not a deliberate action - it's like he forgets how to breathe. It's, as you describe, very much a physical reaction to his emotions and I don't believe at his age that it is manipulative at all. I have read in various places that as children get older and become more aware of what they are doing and the reactions to it, some become deliberate breath-holders (as in the case of WizzyBizzy's DS upthread), so it's good to know what to avoid if that seems to be the case.

In that case I think that 'breath holding' is a very misleading description because it implies a deliberate action to hold one's breath.

If the nursery thought that he had a fit, then he probably did. My children also had fits due to the lack of oxygen, which is why it's called reflex anoxic seizure.

There's often a relationship between the two belgo - we have had 2 (that I know of) genuine anoxic episodes with DS. I called an ambulance the first time as I was so scared. This was when he was much younger - in our case it has become a 'deliberate' thing over time. And to be perfectly honest, I'm still not sure it is 'deliberate' - as in "I am pissed off, I know how to freak everyone out and get my own way, I'm going to hold my breath." I think it's more that he gets so worked up because he hasn't got his own way and massively over-reacts in the way he deals with it, working himself into such a state and that leads to the breath-hold. In our case, playing it down has helped to reduce the incidence (and we were having a lot at one stage - daily incidences). We have a very melodramatic DS though! I have high hopes for him becoming an Oscar winning actor by the age of 20.

WizzyBizzy - did he ever have any medical checks? Some children with the condition need a cardiac pacemaker because the heart slows almost to the point of stop with reflex anoxic seizure. In fact when my dd1 was born, the paediatrician referred her for an ECG and echo-cardiogram (that is quite an expensive test) because she detected a slow heart rate, although fortunately all tests have been negative. My dd1 is also a little drama queen, although maybe that's just co-incidence!

I have seen a patient deliberately breath hold, and that was a very different experience, it was clearly a deliberate, manipulative act to try and get her own way.

That's why with my children I immediately knew it wasn't breath holding. It happened once when I wiped dd1's nose, she simply could not catch her breath and she lost consciousness. By the time we got her to hospital she was still unconscious but breathing again. Very scary, she was only 12 months old at the time. And some people still told me that she was 'manipulating' us

WizzyBizzy - not that I'm suggesting your child needs a pacemaker!

Hi belgo sorry hadn't checked this thread for ages. We had an ECG after the anoxic seizure, all was clear. As you suggest, it was quite clearly different from the breath-holding (although in our case the anoxic seizure came early on so it took a while for me to be clear and confident about the differences), before he was 1 and certainly not manipulative. His breath-holding these days, however, while not exactly manipulating, is definitely about getting mad about not getting what he wants!! The info we were given after the anoxic episode had a section in it about the fact that children who have a propensity for anoxic episodes are often also breath-holders. Seems true in our case.